State Medical Rescue (, PRM) in Poland is a system of free public emergency healthcare established by Ustawa o Państwowym Ratownictwie Medycznym (State Medical Rescue Act), including ambulance service and Emergency Departments (EDs). While in Polish public hospitals and clinics NFZ common public insurance is required, PRM medical services in ambulances and EDs are completely free for everyone. Since 2018 emergency ambulances that operates in PRM, that is Polish 112 and 999 emergency numbers, are operated by public entities only (mostly voivodeships and cities dependent organisations).
Standards
Operating system
At the moment, the operating system of Polish EMS is similar of the Austrian- Franco-German-Spanish delivery model - Integrated EMS of Public Health (IEMS). Paramedics-led team (so called P ambulances) respond to most emergency calls. The paramedics teams are supllemented by gradually diminishing number of physician-led teams (so called S ambulnaces), which staff includes physician. Emergency medicine has been recognized as a medical specialty since 1999. Due to shortage of specialists in emergency medicine, selected other medical specialists (anesthesiology and intensive care, internal diseases, general surgery, pediatrics, pediatric surgery, orthopaedics and traumatology) are allowed to work as ambulance doctors. All these doctors are often referred to as Emergency Physicians. Unlike the German system, the physicians do not respond in separate vehicles, instead staffing the appropriate types of ambulances directly. Transportation to a hospital may, or may not, be an outcome depending on the decision of the team leader, respectively paramedic or physician. The variation occurs in that the ambulance crew may consist either paramedics or emergency nurses, or some mix of the two roles. Each ambulance team, also has a dedicated driver who is usually also trained paramedic. Paramedic-led ambulances will respond to most emergency calls, as in the Anglo-American model, with physicians being dispatched mostly to those calls where there is a potential critical threat to life.
Vehicles and equipment
Poland has voluntarily adopted the majority of the specifications for ambulances of European Standard CEN 1789. Ambulances and equipment used do comply with the technical standards outlined. While design and technical standards are voluntarily complied with, there is virtually no compliance with the visual identity standards described in the Standard. There are also no immediate plans to do so. While plans are in place for the restructuring of some aspects of the EMS system, these are mostly related to staffing configurations and deployment, which are not covered by the technical Standard. It appears unlikely that the proposed changes will have any effect on Standard compliance.
Training
Since 2006, the evolving legal standard of training for Polish paramedics is a three-year bachelor's degree. As an option, those with substantial prior experience may proceed to a degree, following two years of additional study. This program is available in a number of Polish universities, and will completely replace the prior training standard, which consisted of an assortment of short courses. Short courses of various types continue to be offered, but these are now essentially the typical short courses found elsewhere in EMS, including Advanced Cardiac Life Support and Pediatric Advanced Life Support, among others.
System configuration
Ratownictwo Medyczne service delivery units
Państwowe Ratownictwo Medyczne (EMS stations) Lotnicze Pogotowie Ratunkowe (LPR) (Air ambulance stations) Fire Brigade - In the Polish system firefighters provide a level of tiered response to assist Polish EMS in exceptional circumstances, including fires and motor vehicle accidents. The training provided to Polish firefighters is limited to first aid and what might be described as ABC (medicine). As a result, their participation in emergency medical responses is less common than what those in North America would be accustomed to.